Rupture of pregnant uterus

ABSTRACT

To evaluate the risk factors associated with rupture of the gravid uterus and to ascertain the maternal and perinatal outcome of cases presenting with this complication. Design: Retrospective 4 years study on all cases of uterine rupture. Setting: Lady Willingdon Hospital -a teaching institution affiliated to King Edward Medical College, Lahore. Sixty four cases with rupture of uterus admitted from January 1, 1990 through December 31,1993. Main outcome measures: Etiological factors, clinical features, fetomaternal complications and type of surgical procedure performed in each case. Thirty three [51.56%] had rupture of previous cesarean scar, 29 [45.31%] had spontaneous rupture, while 2 [3.13%] had traumatic rupture. Previous cesarean scar was the chief risk factor followed by obstructed labor, grand multiparity and injudicious use of oxytocin. No antenatal care was received during pregnancy by 90.62% cases. Perinatal and maternal mortality rates were 75% and 9.38% respectively. Repair of uterus was done in 34[53.13%] cases, while 30[46.87%] cases underwent hysterectomy. Conclusions: Rupture of uterus is still a common problem. It is associated with considerable perinatal and maternal morbidity and mortality. Previous cesarean scar is the commonest cause for rupture of uterus. Midwife education, regular antenatal care and hospital delivery of all cases with previous cesarean scar are important factors in prevention of this obstetric catastrophe